Runner’s Knee - Runners Knee is the common and broad term to describe any one of the several conditions which affects the muscles around your patella (knee). It it called Runner’s Knee as in the majority of cases it does affect runners - it can affect anyone from beginners to advanced runners.

There is no doubt that the human body can be very resilient. Short of regenerating new limbs, our bodies are capable of recovering from large amounts of damage, including broken bones. With this in mind, many people are happy to let nature take it’s course following an injury, thinking that seeing a physiotherapist will only act to speed up already healing tissues.

Shin splints is the name given to pain in the shin or front of the lower leg, which is usually caused by exercising. Shin splints are caused from the overuse and stress on your lower legs – Anything that involves running can trigger them. People who participate in high impact sports or anything that involves intense running are more prone to the injury due to the added pressure on their legs.

Tennis elbow is the term given to the pain around the outside of the elbow. Its medical term is lateral epicondylitis. Although this injury is very common within tennis players, it isn’t always caused by playing tennis.

Having health insurance can be the difference between recovering from an injury effectively and efficiently through a trusted physiotherapy practice, or relying on lengthy waiting times through the NHS.

We all know that over the last few decades, with the invention of machinery and modern day technology our lives are easier. We have as a society become more sedentary. The average Brit sits around 9.5 hours a day, then another 7 – 8 hours sleeping, our bodies are only active for around 7.5 hours a day. How do we make sure we incorporate more exercise in to our lives? Here are some guidelines to assist you:

BarMob are one of the UK's largest and most active Calisthenics and Street workout teams. We base the foundation of what we do primarily on Bodyweight training. We are lucky to have The Physio Rooms in partnership with us. They help us in maintaining what we do and performing, competing and teaching all year round.

Mike and The Physio Rooms team help us to be at our optimum and in turn this helps us to teach others learning the discipline the importance of good technique and the benefits of looking after yourself when training this sport. Through our partnership we are provided with; in clinic support with treatments of massage, manipulation and taping for our various aches and pains. Mike follows this up with analysis of technique and strength and conditioning programs to help us manage injuries and reach peak performance for events throughout the year.

Mike played a key roll recently when the BarMob took Sweden by storm at the Fitnessfestivalen in Stockholm! Mike worked closely with our athletes to ensure peak condition before the event. Paul took 1st in the men's and we got a 1-2 in the women's with Paula taking 1st and Tori 2nd! We couldn't have asked for a better result! Big respect and congratulations to all the other athletes, and a massive thanks to Mike and The Physio Rooms team for all their help and support.

Some people will spend most of their lives on a constant diet. Why can some people lose weight, what appears to be effortless? Yet others find that it is a real battle and nothing appears to work? The common mistakes people make when trying to lose weight:

• They have not fully committed to losing weight (they are giving it a half-hearted attempt) • You try a new ‘fad’ diet that some celebrity is endorsing and you’re not losing weight (no body is the same, therefore what works for one may not necessarily work for another) • Goal setting – give yourself a realistic, sustainable goal is to lose a steady 1 – 2 lbs a week, rather than in 4 weeks I want to lose 1 stone • Are you accountable for what you are eating and drinking – keep a food & drink diary • Remove any temptation from your reach or sight • Unorganised shopping – buy the majority of the shopping once a week, plan your meals and only buy the foods you require • Ask support – tell friends, family & colleagues you are trying to lose weight and they can support you, some may even decide to join you • Drink enough water – if you are not drinking enough and become a little dehydrated thirst can be mistaken for hunger • You can’t control your portion sizes or have a 2nd helping – use a smaller plate and remove the option of a 2nd helping

1. Take a photo of themselves 2. Track what they are eating, you can use apps like MyFitnessPal 3. Weigh themselves weekly (though this can be demoralising if you have plateaued – keep going) 4. Measure themselves – often you may not lose weight but the inches are dropping off 5. Drink plenty of water 6. Make meals from scratch 7. Remove sugar from their diet 8. Exercise – as it helps with calorie deficit. Although the main benefit is you feel better within yourself and your health starts to improve along with fitness 9. Become more active – use an activity tracker to encourage you to walk more, it’s free and you can fit it in to your everyday life. Aim for a minimum 10,000 steps 10. Eat more vegetables and no more than 2 pieces of fruit a day (fruit still contains sugar) 11. Add variety to your life – try new things, different food, recipes and exercise to avoid boredom setting in 12. Ask for help – if you feel you can’t do it alone seek the help of a professional whether you go to a slimming club, join a gym, hire a personal trainer, they are all there to guide you and give you support

If you have struggled with your weight and want to now lose it for the long term I will soon be running classes to help you - we will exercise, have a weekly weigh in, provide ideas on food choices, write food diaries and encourage you along the way.

Here at The Physio Rooms we pride ourselves on being experts in the field of tendon injuries and rehabilitation. We work tirelessly to keep ourselves at the forefront of the latest evidence based research findings. This enables us to give our patients the best possible advice at each stage of recovery and to optimise their rehab throughout.

Our patients are in the lucky position to have access to one of the UK's leading physiotherapists in Tendinopathy. Tom Goom aka 'The Running Physio' lectures across the UK and internationally, sharing his vast knowledge with other physiotherapists and health professionals. Tom has recently published a research article on Proximal Hamstring Tendinopathy. He worked closely with other world leaders in the area of tendon rehab to bring us a comprehensive rehab protocol for this challenging injury.

Tom has also written for Runner's World, Running Fitness, Cycling Weekly and a host of online sports websites. Along side Tom's work in research we get to see him apply his knowledge daily in clinic. He was recently asked to provide a specialist consulting service with the current world 10,000m and 5,000m world record holder Kenenisa Bekele. Tom sees a variety of sports men and women of all levels from novice runners to elite athletes who compete internationally.

As Clinical Lead at The Physio Rooms Tom shares his knowledge with the rest of team during our regular CPD sessions in order to provide the best possible service and help each patient recover as quickly as possible.

If you have a tendon injury and you would like our expert advice to help you recover then please get in touch today on 01273 667826 or email info@thephysiorooms.com.

More than one thousand athletes swam, biked and ran their way around Hove Lawns during Brighton and Hove's newest and biggest triathlon event. The weekend started early for The Physio Rooms team, arriving on site to get set up for the following day.

Saturday brought big crowds with lots of taping, pre-event treatments and advice being given. As Saturday progressed the weather closed in and by evening time we had big winds, rain and and an angry looking sea. Josie, Lisa and the rest of the organising team had a sleepless night hoping for better weather conditions to allow the Triathlon go ahead in the morning. Sunday morning came and so did the sunshine! Blue skys and a calm sea greeted us at 06:30 on Sunday morning. The first competitors were off at 07:00 with races starting every 30 minutes for next few hours.

What an inspiring event this turned out to be! Huge crowds of people lined the streets to watch and cheer on the competitors. We saw a huge variety of competitors young and old, experienced and newbies as well as the awe inspiring athletes with disabilities. We tended and looked after those who were unfortunate enough to pick up an injury and provided some sports massage for those who had pushed themselves a bit to far while competing. We were kept very busy looking after athletes until mid afternoon.

Once things quietened on the athlete front we continued to give advice and speak with the rest of the 20,000 people who attended the event. We demonstrated our new Motion Guidance Kit which was fun and challenging. We also managed to try a few of the other exhibitor's displays. The Underground 30cal assault bike challenge was particularly tough and I think we have some work to do before we can manage a Barmob muscle up! We also loved the other have-a-go activities which included a real snow ski and snowboard slope, climbing wall, netball court, yoga tent, segway adventure and a range of sports coaching including football, cricket, rugby and even Harry Potter style Quidditch!

The event raised thousands of pounds for its official charities; Bloodwise, Breast Cancer Care, Albion in the Community and Rockinghorse, the fundraising arm of the Royal Alexandra Children’s Hospital, which also supports the Trevor Mann Baby Unit.

All-in-all what a great success the inaugural Brighton Triathlon and Sport and Fitness show was! There was something for all the family to enjoy with lots of new health and exercise activities and great healthy food stands to choose from. We got to treat and meet lots of new people as well as catch up with a lot of old friends. Look out for us there again next year for sure!

We are so proud to have been involved in the Preston Summer Tennis Festival 2016, sponsoring the junior events. The tournament was a huge success seeing over 100 players competing within the various events. It was a fabulous week of tennis enjoyed by players, parents, members and topped off by amazing sunny weather.

Any fan of the Olympics could not fail to be impressed by the amazing performances of Team GB cycling team, between them they won a massive haul of 1 road and 11 track cycling medals. They won six cycling gold medals, four more than any other nation in the Rio Olympics and Great Britain topped the medal table with a total of 12, twice as many as the nearest rivals. Jason Kenny is now on six gold medals, level with Sir Chris Hoy as the most successful British Olympian of all time while Laura Trott has four golds, more than any other British woman in history.
So what's the secret to their success?

Well there's no magic wand to turn you into Laura Trott or Bradley Wiggins!

Consistent, structured training and the right strength work can certainly give you a huge performance boost.

The image below shows the key muscles involved in powering you along on the bike, strengthen those with the right, personalised programme and you'll soon see your PBs falling by the roadside....

Cycling

Some of the key exercises used by these Olympic heroes include: SQUATSLEG PRESSDEAD LIFTS and of course don't forget your CORE!

Unfortunately injury can be a barrier to performance in cycling as with other sports. Back, shoulder and knee pain are common in cyclists. Fortunately we can help you manage any niggles and keep you on the bike, we can also assist with tailored strength and conditioning programs getting the best advice from our highly qualified team, contact us on 01273 667826 at one of our clinics.

Kinesiology tape and sports tape is a thin, stretchy, elastic cotton strip with an acrylic adhesive and it is almost identical to human skin in both thickness and elasticity. In this article we discus the methods used in taping. There is a vast array of taping methods available today, of which many can be used for problems with different anatomical locations. The exact application of each technique may be different depending on the reasoning process of the person who applied the tape. Because of the scant scientific evidence on this area and because each individual is different, there is no truly 'correct' method of applying tape, as each patient has a different problem.

If the tape is being applied by a chartered Physiotherapist then a thorough examination of the problem would have been undertaken, with the clinician then applying the tape with the aim of limiting unwanted movement at a joint or offloading specific anatomical structures where a weakness has been identified. Because there are a huge number of structures that could require support there is no single definitive taping technique. Therefore working with a Physiotherapist who can accurately diagnose and identify structures that might be a potential source of pain is key. Appropriate taping techniques can only be applied with this knowledge.

Literature describes taping in the treatment and prevention of several musculoskeletal conditions such as ankle sprains, patellofemoral pain, wrist sprains and shoulder injuries. Research methods include randomised controlled trials, retrospective and prospective cohort studies, biomechanical lab base studies and correlational epidemiological studies. The scientific evidence for the effectiveness of taping for these problems is mixed, but the clinical use of taping techniques is widespread. The ankle is the most commonly taped joint in football.

The type of taping technique and the choice of material used is largely based on the athletes preference, with this decision largely based on custom, superstition and comfort (both physical and mental). Ankle tape is also appropriate following acute ankle sprain. As well as immobilisation, a compression bandage can help to limit swelling. In the recent study by Barton et al 2105 BJSMphysiotherapists advocated taping as a major component of the management of anterior knee pain. It was found that a combination of taping, manual therapy, appropriate exercise prescription, gait analysis had the most improved results for patients with anterior knee pain.

Here at the Physio Rooms we follow all methods of taping and where necessary are advocates of its usage. If you have any questions on taping or are experiencing a pain which could be alleviated by taping then please dont hesitate to contact us on 01273 667826 and we would be happy to share our knowledge.

The anterior cruciate ligament (ACL) is a strong ligament which runs diagonally through the middle of the knee. It prevents the femur (thigh bone) from sliding out in front of the tibia (shin bone) and gives rotational stability to the knee.

The ACL is one of the most common knee injuries that occur in sport. Most ACL injuries occur during non-contact running, jumping, and landing tasks with inadequate neuromuscular control of the lower limb. That is when you slow down very quickly, change direction rapidly, or land incorrectly from a jump. This is commonly due to decreased knee flexion (knee bend), increased knee valgus (knee collapsing in), and internal rotation at the hip during landing and cutting movements. It can also happen through direct contact or collisions such as a football tackle.

Horsley (2015) outlines the risk factors that influence the alignment through the lower limb:

Weak muscles: gluteals, quadriceps, foot supinators

Over recruitment: hamstrings, hip adductors, trunk flexors

Decreased proprioception (joint position sense)

Reduced dorsiflexion of the ankle

Reduced tibial internal rotation

Usually you will know if you have injured your ACL as you may hear a ‘popping’ sensation in the knee. You may also feel the knee ‘give way.’ There is often severe pain and inability to continue with sporting activity, the patient is often unable to weight bear. Swelling begins quite quickly within a few hours as the ACL has an abundant blood supply.

There are different severities of ACL tear ranging from a grade one tear (the ligament is mildly damaged but is still able to keep the knee joint stable) to a grade three tear (the ligament has been snapped in two and the knee joint is unstable).

Treatment for an ACL tear will depend on the severity of the damage to the ligament and the patient’s individual needs. For example the young athlete involved in agility sports will most likely require surgery to return safely to sports, versus the less active individual that could be managed with non-surgical intervention.

Surgical treatment involves removing the ACL and replacing it with a graft (often a section from the patella tendon or hamstring) which is then screwed in from the femur to the tibia to replicate a new ligament. Rehabilitation from surgery is vital for return to sports and daily activity. A physical therapy programme will focus on regaining knee strength, movement, and stability. It usually takes 6 months to a year to make a full recovery from ACL reconstruction; however this is very dependent on the individual and how closely you follow the programme and advice from your therapist.

If you are suffering with knee pain or want to know more about the treatment for ACL injuries please get in touch with one of our highly trained Physiotherapists or contact us on 01273 667826 at one of our clinics.

This series of exercises are good to strengthen and mobilise the lower body for both competitive and recreational tennis players. Using a variety of functional strength, stability and control you can use the set as an ideal warm up programme that can be followed before playing tennis.
Due to the versatility and lack of any major equipment they are the ideal set of exercises for tournament play. Keep your eyes pealed for any lunges at the side of the courts!!

It is the peak of the tennis season, the French Open finals have been played and Wimbledon is round the corner - now is the perfect time to highlight some of the work we do with some of Sussex's top ranked tennis players. With that in mind we asked long time college and ITF professional tennis player Keelan Oakley to share his experiences working with The Physio Rooms team. Keelan is an ITF professional tennis player, with a career high ranking of 997. He currently tours the ITF circuit playing challenger events across Germany, Egypt, Cyprus, Great Britain and many other international venues. Keelan is coached by Barry Fulcher (@BF_Tentrade) out of Preston Lawn Tennis Club who has recently achieved number 1 ranking in men's over 35 tennis. Keelan also works closely with Brendan Hayes (@theconditioning) and has a long term working relationship with The Physio Rooms team, namely clinical lead Tom Goom.

In Keelan's own words...

"Throughout the 2102 season I struggled with low back pain. This pain gradually got worse with symptoms spreading to my left leg. By the end of the year I was having difficulty walking. After a MRI it was discovered that I had severe intervertebral disc damage that would require surgery. In Feb 2013 I had back surgery on a disc bulge L4/L5, the surgeon predicted it would be a few months or so at least before I would be back on court even to do the absolute basics of hitting for a light hour with minimum movement.

At that time I was having physio twice a week and we managed to halve the recovery time and I was back on court in about 4/5 weeks. This was great as I was able to prepare well for a summer of competing and I reached a career high ranking of 997 ATP in the next 6 months.

Unfortunately I had another flare up at a tournament in Cyprus. It didn't require surgery but I was out for another 9 months. During the 9 months I had physio once a week and could do some really limited stuff on court and bits in the gym. Tom had the idea of getting my 'team' together (physio Tom, Fitness trainer Brendan, coach Barry) so we could all discuss the best way of getting me back on court as soon as possible.

This really helped speed up my recovery as everybody was working towards the same goals, we covered everything from what Tom and Brendan would be doing with me (a lot of hamstring work!!) and a detailed breaking down of my footwork and technique to find a way to prevent a complete blowout whilst in competition. This involved extensive video analysis of my technique. Going back to basics with footwork drills and agility. We built strength and control through gym sessions.

On court we worked endlessly to build new movement patterns, it really felt like I was learning to play tennis all over again which in essence is what we were trying to achieve to prevent further break downs. We would (and still do) meet every 2/3 months to keep on top of my programme and see if there are any ways we can improve it and so far so good! A few exercises from Tom and a massage once a week, enjoying IP sessions a lot more than rehab!!"

Our lifestyles have changed dramatically in the past thirty to forty years. We are spending more and more time sitting down at computers or mobile devices, watching television and driving and this means we are seeing neck pain becoming increasingly more common. Neck pain has now joined lower back pain as one of the two most common pain locations in the body. Acute neck pain (pain that manifests abruptly) generally has little to do with this change in our society, but can be caused by sudden jerky movements of the head and neck, or by trauma injuries from sporting accidents and falls.

Whiplash occurs when the head is suddenly moved backwards and forwards, causing the muscles and ligaments of the neck to strain and in some cases tear. Whiplash is commonly experienced in rear-end car collisions and can produce pain and aching to the neck and back, referred pain to the shoulders and often headaches.

Simple neck pain implies pain that arises due to relatively minor problems with the muscles, ligaments joints and nervous systems of the neck. Simple neck pain can come on after a minor injury or sprain but in many cases no injury can be identified. It can arise after something as simple as sleeping badly in bed at night. This type of pain comes about because the sprained tissue becomes irritated and sometimes inflamed which causes pain signals to be sent to the spinal cord.

However, most neck pain that is not caused by whiplash or trauma and has a postural component as part of the underlying problem. Sitting in front of a computer for long periods with static seating frequently leads to muscular, joint and neural pain in the neck, back and shoulders.

It is estimated that 45% of the working population is affected by neck pain. Therefore it is very important to understand the different aspects of poor posture that contribute to this type of pain in order to prevent and manage it.

A common cause of postural neck pain is the forward head and shoulder posture. This occurs when the neck slants forward, placing the head in front of the shoulders (this can be observed while working at a computer, laptop, ipad, iphone etc.) This position places undue stress on the vertebrae of the lower neck. The muscles of the upper back are also continually overworked to counter-balance the pull of gravity on the forward head. Forward shoulders and a rounded upper back with increased extension of the cervical spine often accompanies this position. This leads to very tight pectoral muscles and causes a lot of tension between the shoulders as well as contributing to the neck pain.

Physiotherapy assessment and treatments such as manual therapies, massage and stretching can help ease symptoms. Postural re-education is key. A patient specific exercise program to help mobilise and strengthen the back, neck and shoulders in order to pull the shoulders back into a neutral position, can alleviate some of this tension and pain. Stretching before and at intervals during the working day can also do wonders for tight, tired muscles.

Another way to minimise the risk of developing postural neck pain, or to manage it if you already suffer from it, is to adjust your workspace around you so that you can work comfortably.

Desk

Most desks have a fixed height; therefore it is important to ensure you have an adjustable height chair so that your arms can operate the keyboard comfortably

Chair

Always sit as far back as possible in the seat so that your lower back is well supported

The back of the chair should be high to support the middle back

Your chair height should let you type with your forearms placed horizontally on the keyboard

Try to keep your feet flat on the ground, if your feet dangle off the ground when you’re sitting fully back in the chair, using a foot rest is a good idea

Keyboard

Pull up close to your keyboard

Position it directly in front of your body

Wrist rests can help maintain a neutral wrist position when you are taking a break from typing but are not recommended for use during typing as typing in this position may cause carpal syndrome in the wrist

If you are suffering with neck, shoulder or upper back pain please get in touch with one of our highly trained Physiotherapists or contact us on 01273 667826 at one of our clinics.

Ever since athletic competitions began coaches and athletes have strived to make their running more efficient. Despite this there has been considerable debate over what techniques actually create a more efficient style. Classically an 'Endurance Template' has been recommended:

While this has been widely used there is minimal evidence to suggest it's a recipe for success or a running style we should all aspire to. Recent research from Cardiff Metropolitan University has highlighted that multiple factors can affect efficiency but a key factor appears to be how a runner pushes during propulsion. Dr Isabel Moore and her team identified that as a runner's economy (a measure of efficiency) improved, their leg position at toe-off changed; the knee was slightly more flexed and the ankle slightly less plantar flexed:

If we can improve push off we can, in theory, improve efficiency and potentially make someone faster. The challenge is determining how we might do that with each individual. We would hope that the right running cue could help the runner on the left change her position at toe-off and become less 'bouncy'. Recent developments in mobile technology allow us to measure vertical oscillation in clinic and determine if this 'bounciness' changes with gait-retraining. In the case of the lady above she was running with an ankle injury which may well have affected her gait and would also need to be addressed to help efficiency.

It's important to recognise with running that there are many factors that interlink and influence performance and load on the tissues. There's no one-size-fits-all approach! They key is finding what works best for each individual runner. This was highlighted recently by a patient advised to increase his cadence (amount of steps per minute) to reduce injury risk. While this can indeed be good advice for some it certainly isn't a cure-all! In this gentleman's case it lead to a stuttered running style with very little length in the stride (picture on the left below).

Running Example 2

A final, crucial point to consider is that video alone cannot tell you what style is best for you. It's really important to see how changes to your running gait feel and whether they actually feel easier. It often takes time to adjust to changing your running and it can feel difficult initially but if a running cue feels like a lot more effort it's probably too big a change.

For more information on running gait analysis or to arrange an appointment please get in touch with Tom one of our senior, highly trained Physiotherapists or contact us on 01273 667826 at one of our physio clinics.

Massage may have developed a reputation over the years as a decadent treat for people who love to be pampered and spoilt - it is seen as a luxury. New studies are showing it has a wide variety of tangible health and wellbeing benefits. These benefits were first realised by the ancient western and eastern civilisations dating back as far as 3000 years ago when the discovery that massage therapy had many positive effects on one’s health and considered a valuable holistic method for healing. These benefits range from relieving migraines and stress to improving circulation and having the ability to rehabilitate physical functions. Hollistic Massage endeavours to reduce pain and tension, restore function, and improve circulation all in conjunction with the individual’s health and well-being. Three key areas describe this style of massage:

It is not just for pampering - The massage has a focus on maintenance and supporting your health and well-being. The massage will leave you feeling very relax but equally will provide you with muscle tension relief, improvement in flexibility, improvement in circulation and aids with the relief of pain and stiffness. I believe massage therapy should form part of an individual’s health and well-being maintenance programme and not just as a luxury!

Working with your body - Identify imbalances and points of tension. Releasing the tension built up using various massage and fascial release techniques such as Trigger Point Therapy, Muscle Strengthening Techniques, Muscles Energising Techniques and aspects of neuromuscular techniques.

Not just for sport people - Massage Therapy complements Physiotherapy, however muscle tension, joint stiffness and pain and stress can affect anyone and can brought by everyday activities such as gardening or driving. Postural problems occur as a result doing sedentary activities such as sitting at a computer all day. Repetitive strain injury, headaches, migraine, stiff neck and back can all be relieved by massage therapy.

As we are well into the excitement of the RBS 6 nations, you can see the gruelling nature of the sport and how these athletes need to do more than just strength and conditioning to stay injury free and match fit. Georgie our Pilates Teacher talks about her experiences with the sport. "I’ve been working with Harlequins Rugby team for the last 18 months doing one to one Pilates on the reformer with the players. The reformer is a versatile piece of Pilates equipment that has springs which you add for resistance. It is used to strengthen the core, work the body uniformly, and increase flexibility and mobility.

There are many professional rugby clubs that have also jumped on the band waggon of Pilates and have it as an integral part of the players fitness program. At Harlequins we have key players that are on my list for a session each week; those that are slightly older and really benefit from the mobility side of the session, key players that are in the starting 15 that the coaches want match fit week on week out, and those that have long term injuries that really benefit from the low impact and specific rehab strengthening exercises.

Pilates offers a completely different element to the rugby players overall program. It gets the players away from the high level, high impact muscle activation used at the gym or in their fitness session, and gets them tapping into a new side of training their bodies working more holistically, and at a lower level to reintroduce neuromuscular training patterns and activating weakened areas from injury back to where they should be. As you tend to feel so good after coming away from a session on the reformer you can imagine how popular Pilates has become at the club."

So for those of you out there unsure or nervous to give it a go the Pilates Reformer is a truly versatile piece of equipment for any age and gender and after a few sessions you’ll be hooked! As if you need convincing here is a few words from Danny Care who plays for England and is the Captain of Harlequins Rugby Team:

"Georgie has been vital for me in ensuring I am fit and ready to go for every training session and more importantly every match. I often turn up to training sore with a tight back but with Georgie's help and guidance through Pilates she ensures I am in great shape to train. She is incredibly professional and a joy to work with."

To find out more about Pilates please contact Georgie our Pilates Teacher. Alternatively for any help or advice or to book an appointment please contact us at one of our clinics.

Sometimes back pain causes pain in the legs which doctors often refer to as ‘Sciatica’ because the sciatic nerve, which runs down the back of the leg, is most commonly involved. Pain can actually be felt in the buttock, back of the thigh, calf or into the foot. There is nothing wrong with the leg itself, but the pain is caused from an injury on the spine irritating the nerve. These symptoms are often described as referred pain. You may also experience numbness or pins and needles in the legs and feet.
Do I have Sciatica?

Your physiotherapist can perform certain clinical tests to give an indication as to whether symptoms in your leg are coming from your back (referred pain) and whether the is nerve root irritation (radiculopathy /radicular pain) which along with your clinical history might also point to a more specific problem. If your physiotherapist thinks there is a specific structural problem they may refer to your doctor accordingly, but this is very rare.

Why am I getting pain?

Sciatica 1

Your back is made up of 24 bones known as vertebra sitting one on top of the other. Where each vertebra meets another 3 joints are formed that include: 2 bony (facet) joints at the back and a soft inter-vertebral joint formed by the discs at the front of the spine. The discs act as shock absorbers and the facet joints control movement of the spine. At each joint there are also ligaments and muscles that attach to the vertebrae to control and assist the movement of the spine.

Sciatica 2

Sciatica 3

What can help?

Physiotherapy!

A physiotherapy assessment can identify reasons why your pain is persisting and ease your pain. Your physiotherapist may choose to perform massage, spinal mobilisation or manipulationand show you some pain relieving exercises. Whether you have stiffness, weakness or instability, these exercises and treatments will help you return to your normal activities sooner. You may also gain a better understanding of what causes your pain and how to prevent the frequency of future episodes and manage them independently, if they do occur. If you find symptoms are persisting and you are not returning to normal activities, to reduce pain and improve your function your physiotherapist may develop more specific conditioning exercises for you based on your presentation.

Medication

Over-the-counter pain medication like paracetamol and ibuprofen are very effective for initial pain symptoms. Don’t wait until you have severe pain before you take pain medication. If the pain is limiting your ability to move and exercise it could also affect the time it takes for you to recover. If you have any other medical conditions you should always consult your doctor before taking any pain medication.

Exercise

Your physiotherapist can also guide you on the most effective way to ease stiffness and pain. Exercise is important as your pain eases for improving muscular control, strength and stamina, general fitness, flexibility and improving your mood. If pain persists, the lack of normal movement can cause muscle to become idle and make it more likely that you could reinjure your back again in the future. So it’s important that you don’t rest for too long and you do as many of your normal activities as possible. If you are in so much pain that you need prolonged bed rest try to make sure that you gently move your back as pain will allow.

Do I need to see the doctor?

If you are in severe pain or prolonged pain that doesn’t resolve after 4-6 weeks then you may need to see a doctor. Also if you notice weakness of the muscles in your leg, especially if you can’t pull your foot up towards you, you should see a doctor. You should also seek medical advice immediately if you lose control of your bladder or bowel function or you have numbness or pins and needles in both legs.

(Sources are available on request)

If you are suffering from any of these symptoms or you think you might have Sciatica please get in touch with Guy one of our senior, highly trained Physiotherapists or contact us on 01273 667826 at one of our clinics.

You've put in the miles, sacrificed your lie-ins and bought the lycra, now marathon and half marathon day is on the horizon. Make sure you're in top shape at the start line with our DOs and DON’Ts for final marathon preparation: DO

Rest - our muscles are fueled by glycogen, a carbohydrate, which is depleted after long periods of exercise. Resting in the days leading up to the marathon allows glycogen levels to increase. Think of it like filling up your car for a long journey, so now you need to think about what fuel...

Re-fuel - as a general guide increase carbohydrate intake for 36-48hrs before the race. Carbs with a low glycemic index (GI) are best as they release energy for a longer period. This includes wholemeal pasta, roasted and salted peanuts, milk, fruit (especially cherries and grapefruit) and wholemeal bread. Mash potato, chips and white rice are considered high GI and are probably best avoided pre-marathon. In terms of how much to eat, comfort is important. Don't be tempted to completely stuff yourself and risk feeling ill after! Elite athletes aim for 10 - 12 grams of carbs per kilogram of body weight per 24hrs. Meaning an 80kg runner would aim to eat 800 - 960 grams of carbohydrate per 24hrs. This is probably a little excessive for most and not the best thing to try for the first time on marathon weekend!

Prepare - got a pen and some paper? Right, now make a list of everything you need for race day! Shorts, shoes, socks, GPS watch, race number, safety pins, emergency loo roll, gels, post race bag, sweat band, vaseline, pre-race breakfast, and anything else you can think of should go on that list. Get it all ready and laid out the day before so you don't have a thing to worry about on marathon day. Also give some thought to how you'll get to the start line and when you'll leave as roads are usually closed. It sounds like a military operation but the aim is to make it as stress free as possible and help you enjoy the day. Download our race day checklist here.

Plan - decide how you want to approach the race and what your goals are and use this to guide your race plan. It's very easy to start too quickly and pay the price later on. A marathon is a long way - save some energy for the end. You may have heard of 'negative splits' - the idea being to run the second half of a race quicker than the first. Some will aim to do this for a marathon but those last 5-6 miles are seriously tough so it may not be realistic. Another approach is to aim for an even, comfortable pace the whole way. This can help prevent 'hitting the wall' but requires discipline. Work out your target pace and try and stick to that, resist the temptation to speed up early on as you run the risk of paying for it in the later stages. A GPS watch can be really helpful for monitoring speed but failing this run near a pacer or chat to fellow runners to get an idea of pace.

Relax - once you're prepped and ready relax, there is nothing more you can do! Your marathon is about the last 4-5 months of training not the final few hours. You've put the work in, put your feet up and chill out!

DON’T

Panic - it's very common for people to have a 'taper tantrum' and panic just before a race. Suddenly you assume everything will go wrong and you're totally unprepared. In fact we have had people call us at 10pm at night wanting an emergency physio appointment the night before a marathon! You will get little niggles in the taper but they'll settle and be fine for the race. Stay calm, it'll all be fine.

Test out new stuff - race day is not the time to try out new shoes, a different running style or a radical new diet. Keep marathon day for what you've tried and tested. If it works for you, stick with it!

Squeeze in an extra run - the temptation to squeeze in more miles or compensate for missed sessions can be very high leading up to the big day. Resist! Stick to your taper, rest and re-fuel.

On race day...

Use the morning routine you've used for your long runs (adapt it as needed for your start time). Get an early start to give you at least 2 hours between eating and racing. Stick to whatever breakfast you've tried and tested! Get to the start line with plenty of time. Try to have used the toilet well before start time as queues can be long on race day. Stick to the plan, probably the most common mistake to make on race day is to run the beginning of the race at a much faster pace than planned. This will drain you precious glycogen stores and is a sure fire way to increase your risk of hitting the dreaded wall. Stick to your pre-race plan and keep a close eye on your pace.

Finally and most importantly enjoy the day, you have worked long and hard to get to the start line now soak up the atmosphere and enjoy the experience.

For any pre-race sports massage or advice please feel free to contact us we are more than happy to help loosen and lighten legs and help you plan your race strategy. For post-race recovery why not come for a massage at one of our clinics and tell us how well you did!

We are proud to have our Portslade Clinic inside Underground Gym, a performance led gym. They have very unique facilities and offer combat classes which are showing an increase in their popularity worldwide. Read on to see what they have to offer:
"We are proud to say that Underground Gym is not only Brighton's largest Strength and Functional Gym but also the home for some of the South Coast’s finest combat instructors who will make you feel welcome from the moment you walk onto the mats.
At Underground Gym we cater for all levels of ability. In the first session you will be shown correct techniques and how to progress further within your chosen class. If you find training by yourself a chore, a Combat class could be for you. Research shows that people who train in a class environment actually reach their goals quicker than regular Gym users. We put this down to making fitness fun, and at the Underground Gym we have a real mix of members who all help push each other in every session.

Come and learn a new skill, meet friends, have fun, and burn a truckload of calories in Brighton's premier fitness facility."

Meet the Instructors and their classes:

John Hathaway – MMA

Taught by UFC fighter John ‘The Hitman’ Hathaway. John breaks down what has given him a 6-1 record in the UFC and a 17-2 record overall – Johns focuses on Wrestling, Submissions and Ground & Pound.

Jack Magee - Submission Grappling

This class is taught by BJJ Black Belt Jack Magee who combines the exercises and drills used by professional fighters and blends them into a fun session that will give you great confidence in ground fighting.

Danny Zaharan - K1 - Kickboxing

Danny’s class involves low kicks, knees, and involves a strong Muay Thai Boxing influence. This is great class for anyone who wants learn the art of stand up fighting.

We are very pleased to be joining in with Underground Gym's charity open day on 20 and 21 February 2016, we will be available for Free Physiotherapy Drop Ins on the Saturday. These short sessions are free of charge and a great opportunity to discuss any aches or pains that you are experiencing. We will then be able to advise what would work best for you; maybe some hands on treatment, or an exercise prescription to get you out of your current injury. If you've had a niggle that you have been trying to ignore here is a chance to get it looked at! So if you are interested in checking out Underground Gym pop along on the open day and enter your name into our prize draw where you could win yourselves a free sports massage with one of the team!

1. Avoid training error – 80% of all running injuries are caused by training error. At The Physio Rooms we encounter this on a daily basis. Some simple guidelines to follow are: make sure increases in training volume are GRADUAL. A 10% increase in total mileage per week is best. Mix intensities – 80% low intensity running to 20% high intensity hill work or sprints. Your long slow runs must be slow, the plan with these runs is to build endurance, it’s about time on your feet not the speed at which you run. Implement a step up step back training program. This involves increasing mileage for three weeks and decreasing on the fourth week. Plan each run, they should have a different objective to ensure variety in your weekly training schedule.

2. Strengthen and conditioning – a recent study has shown that implementing a basic strengthen and condition program decreased injures in runners up to 50%. Strengthening the body’s muscles and tendons enables us to cope with the stress and loads of endurance running better. At The Physio Rooms we have also noticed that our athletes who follow our strengthen and condition programs see big improvements in overall performance with many achieving personal bests in their events.

3. Running shoes and equipment – some recent trends have suggested that using a minimal shoe and running on the forefoot works best. As a general population almost 98% of us naturally heal strike. At The Physio Rooms we have seen a big increase in the number of injuries presenting in clinic due to a sudden change in running style. The most important piece of a advice to follow when buying new running shoes is that new shoes should feel comfortable to run in. Try and spend some time running in them before you buy. Most shops have treadmills these days. We recommend Nick Rivett for all your running equipment needs.

4. Nutrition – science suggests that you should fuel your muscles and liver before your train or run the big event. Try fuelling your body with approximately 250/300 calories about 1-1.5 hours before you run. Eating too close to a run can cause cramp and not eating enough could lead to a lack of energy. A basic rule of thumb for longer runs is that we need about 100 calories after the first hour and approximately 100 calories every 45 minutes after that.

5. Hydration – pre run try to drink about 500ml of water 2 hours before and then just before approximately 150ml. During the event try and drink about 200ml every 20 minutes. It’s important to remember here that the stomach can only empty 800-1000ml of fluid every hour and running on a very full stomach can be very unpleasant.

Download our handy injury prevention cheat sheet here:

PDF version

JPG version

For any help or advice or to book an appointment please contact us at one of our clinics.